CHEST Guidelines-Infections-and-Lung-Cancer

Infections-and-Lung-Cancer_chest

Pdf Summary

Lung cancer, primarily caused by smoking, remains the leading cause of cancer death globally. Preventative strategies focus on smoking cessation, but identifying additional risk factors, especially for non-smokers or those with a history of smoking, is crucial. Recent research highlights that infections, including lung infections, may increase lung cancer risk. <br /><br />Zheng et al.'s study, featured in CHEST, utilizes UK Biobank data, which comprises about 500,000 adults, to explore links between infections and lung cancer. They identified infections, particularly those affecting the lower respiratory tract, bloodstream, and bacterial in nature, as significant risk factors for lung cancer, independent of smoking history. The association persisted even when controlling for other variables and accounting for cases of multiple infections. Notably, the risk remains elevated over 10 years after infection, suggesting a potential causal role of infections in lung cancer development beyond short-term effects or reverse causation due to undiagnosed cancer.<br /><br />Furthermore, genetic analyses suggest a genetic susceptibility related to immune response might underlie this association, though disentangling genetic predisposition and immune-related risk factors is complex. While smoking is a significant confounding factor due to its impact on immunity, the stronger infection-cancer association in non-smokers supports the hypothesis that infections independently elevate lung cancer risk.<br /><br />Understanding mechanisms, such as systemic immune changes and inflammation leading to lung cancer development, is critical. Social determinants like socioeconomic status also influence inflammation and may play a role in this risk.<br /><br />Thus, these findings could lead to new lung cancer prediction models, incorporating infection history, to identify high-risk populations, including non-smokers. Future studies should investigate these associations across diverse populations and further explore biological mechanisms. This approach may complement existing screening criteria, potentially improving early identification of lung cancer risk beyond smoking history.

Keywords

lung cancer

smoking cessation

risk factors

infections

UK Biobank

genetic susceptibility

immune response

socioeconomic status

prediction models

screening criteria